Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial

Leanne Bisset, Elaine Beller, Gwendolen Jull, Peter Brooks, Ross Darnell, Bill Vicenzino

The objective of this study was to investigate the efficacy of physiotherapy compared with a wait and see approach or corticosteroid injections over 52 weeks in tennis elbow. 198 participants aged 18 to 65 years with a clinical diagnosis of tennis elbow of a minimum six weeks' duration received eight sessions of physiotherapy; corticosteroid injections; or wait and see approach. The authors concluded that physiotherapy combining elbow manipulation and exercise has a superior benefit to wait and see in the first six weeks and to corticosteroid injections after six weeks, providing a reasonable alternative to injections in the mid to long term. The significant short term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in the management of tennis elbow.

BMJ, doi:10.1136/bmj.38961.584653.AE (published 29 September 2006)

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